title: Clearance of Candida colonizing the urinary bladder by a two-day amphotericin B irrigation.
abstract: The minimum duration of continuous amphotericin B irrigation (50 mg/liter/day) required to clear the candida colonizing the urinary bladder was investigated. Eleven in vitro experiments revealed a consistent candidicidal effect within 48 hours with 25 and 5 mg/l of amphotericin B concentrations attainable in the bladder. Hospitalized nursing home patients with candiduria were treated with two-day irrigation according to the protocol. The protocol consists of the use of a newly inserted catheter for the irrigation, subsequent washout of the residual drug, and immediate sampling of urine for microscopic examination and culture after the procedure. In 47 of 65 (72.3%) cases yeast was cleared. In the remaining 18 the candida persisted. Of the latter, ten received additional irrigation for an average of 7.3 days (range: 4-12 days). In all ten cases funguria continued. Two-day irrigation saves time and expense, and is as effective as the five-day procedure in eradicating the yeast on bladder mucosa. Because of the relatively short irrigation time, the protocol may be useful in clinical evaluation of the site of urinary candidiasis.
authors.affiliation: Northwestern Medical School, Department of Medicine, Columbus Hospital, Chicago, IL.
authors.forename: C C
authors.initials: CC
authors.lastname: Hsu
authors.forename: B
authors.initials: B
authors.lastname: Ukleja
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002175:Candida / Q000187:drug effects*; D002177:Candidiasis / Q000188:drug therapy* / Q000652:urine; D002408:Catheters, Indwelling; D003428:Cross Infection / Q000188:drug therapy* / Q000652:urine; D003470:Culture Media; D006801:Humans; D007507:Therapeutic Irrigation; D001743:Urinary Bladder / Q000382:microbiology*; D014546:Urinary Catheterization
chemical_list: D003470:Culture Media; D000666:Amphotericin B